PMID- 18828899
OWN - NLM
STAT- MEDLINE
DCOM- 20081210
LR  - 20181113
IS  - 1475-2875 (Electronic)
IS  - 1475-2875 (Linking)
VI  - 7
DP  - 2008 Oct 1
TI  - Therapeutic and prophylactic effect of intermittent preventive anti-malarial 
      treatment in infants (IPTi) from Ghana and Gabon.
PG  - 198
LID - 10.1186/1475-2875-7-198 [doi]
AB  - BACKGROUND: Intermittent preventive treatment in infants (IPTi) with 
      sulphadoxine-pyrimethamine (SP) reduces the incidence of malaria episodes in 
      young children. The exact mechanism by which the protective effect is mediated 
      needs to be defined. This study aimed to investigate therapeutic, prophylactic, 
      and possible exceeding effects of SP-based IPTi in two clinical trials. METHODS: 
      Protective efficacies from two IPTi trials performed in Kumasi, Ghana, and 
      Lambarene, Gabon, were assessed for overlapping time series of 61 days. For 
      six-months periods after each of three IPTi doses a multivariate Poisson 
      regression model with the respective cohort as co-variate was generated and 
      effect modification of protective efficacy with time strata was evaluated by 
      log-likelihood tests. RESULTS: Protective efficacies were not significantly 
      different between the two study cohorts. Study-cohort corrected protective 
      efficacy was highest for the first 61 days after each IPTi application and 
      decreased continuously. For the first 61 days after IPTi-1, IPTi-2, and IPTi-3 
      the protective efficacy was 71%, 44%, and 43%, respectively. A reduction of the 
      malaria incidence rate was detectable for the first 60, 30 and 40 days after 
      IPTi-1, IPTi-2 and IPTi-3 drug application, respectively. After IPTi-3 a higher 
      risk for malaria could be seen after day 60. This effect was mainly based on the 
      overwhelming influence of the Kumasi cohort. CONCLUSION: The results suggest that 
      SP-based IPTi mainly works through a therapeutic and prophylactic effect over 30 
      to 60 days after drug application and that a sustained effect beyond 
      post-treatment prophylaxis might be very low. TRIAL REGISTRATION: Data analysis 
      from clinical trials NCT ID # 00206739 (Kumasi Trial) and NCT ID # 00167843 
      (Lambarene Trial), http://www.clinicaltrials.gov.
FAU - May, Jurgen
AU  - May J
AD  - Research Group Infectious Disease Epidemiology, Bernhard Nocht Institute for 
      Tropical Medicine, Bernhard-Nocht Strasse 74, D-20359 Hamburg, Germany. 
      may@bni-hamburg.de
FAU - Adjei, Samuel
AU  - Adjei S
FAU - Busch, Wibke
AU  - Busch W
FAU - Gabor, Julian J
AU  - Gabor JJ
FAU - Issifou, Saadou
AU  - Issifou S
FAU - Kobbe, Robin
AU  - Kobbe R
FAU - Kreuels, Benno
AU  - Kreuels B
FAU - Lell, Bertrand
AU  - Lell B
FAU - Schwarz, Norbert G
AU  - Schwarz NG
FAU - Adjei, Ohene
AU  - Adjei O
FAU - Kremsner, Peter G
AU  - Kremsner PG
FAU - Grobusch, Martin P
AU  - Grobusch MP
LA  - eng
SI  - ClinicalTrials.gov/NCT00167843
SI  - ClinicalTrials.gov/NCT00206739
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20081001
PL  - England
TA  - Malar J
JT  - Malaria journal
JID - 101139802
RN  - 0 (Antimalarials)
RN  - 0 (Drug Combinations)
RN  - 37338-39-9 (fanasil, pyrimethamine drug combination)
RN  - 88463U4SM5 (Sulfadoxine)
RN  - Z3614QOX8W (Pyrimethamine)
SB  - IM
MH  - Antimalarials/*administration & dosage
MH  - Drug Administration Schedule
MH  - Drug Combinations
MH  - Gabon
MH  - Ghana
MH  - Humans
MH  - Infant
MH  - Malaria, Falciparum/*drug therapy/*prevention & control
MH  - Pyrimethamine/*administration & dosage
MH  - Regression Analysis
MH  - Sulfadoxine/*administration & dosage
MH  - Time Factors
MH  - Treatment Outcome
PMC - PMC2586636
EDAT- 2008/10/03 09:00
MHDA- 2008/12/17 09:00
PMCR- 2008/10/01
CRDT- 2008/10/03 09:00
PHST- 2008/08/05 00:00 [received]
PHST- 2008/10/01 00:00 [accepted]
PHST- 2008/10/03 09:00 [pubmed]
PHST- 2008/12/17 09:00 [medline]
PHST- 2008/10/03 09:00 [entrez]
PHST- 2008/10/01 00:00 [pmc-release]
AID - 1475-2875-7-198 [pii]
AID - 10.1186/1475-2875-7-198 [doi]
PST - epublish
SO  - Malar J. 2008 Oct 1;7:198. doi: 10.1186/1475-2875-7-198.